Flashcards in Renal Deck (31):
what endocrine work do the kidneys do?
activates vitamin D
controls blood pressure via RAAS
what are some renal investigations that can be done by looking at the urine?
dipsticks - glucose/blood/protein/WBC's
what are some renal investigations that can be done by looking at the blood?
glomerular filtrate rate
what imaging tests can be done for renal?
what investigations can be done via looking at the tissue?
what are some consequences of renal failure?
high potassium - cardiac arrest
accumulation of waste products - ureamia
lack of erythropoietin
lack of vit d
what are some causes of renal failure?
autoimmune - glomerulonephritis
cancer - myeloma
what drugs can cause renal failure by exacerbating pre existing disease?
idiosyncratic reactions - penicillin/NSAIDS
what infections can cause renal failure
recurrent ascending UTI's
what kind of obstructions can cause renal failure?
polycystic kidney disease
what are the 2 forms of renal disease?
what is acute renal failure?
-acute loss of renal function - normal/low absent urine -output
-life threatning - hyperkaleamia/uraemia, fluid retention, hypertension
is acute renal failure reversible?
does acute failure happen in healthy kidneys?
usually pre existing disease
how to manage acute failure?
manage underlying cause
treat effects - potassium/fluid removal or replacement
what is chronic renal failure?
gradual progression of renal impairment
end stage renal disease where GFR is 5% of norm
progression depends on underlying cause and modifying factors
what are the most common causes of chronic renal failure?
chronic renal infection
polscytic renal disease
what are the effects of chronic renal disease?
uraemia - reduced immunity/platelet function/malaise/nausea/itch
fluid retention - hypertension/odeama
lack of erythropoietin - anaemmia
renal osteodystrophy - secondary hyperparathyroidism
how to treat chronic renal failure?
avoid further damage - control hypertension/diabetes, immunosuppresion, avoid/reduce drugs, treat any obstructions
- correct anaemia - erythropoietin injections
-correct vit d deficiency
types of dialysis?
what are some problems that may rise from transplant?
rejection - acute/chronic
immunosuppresion - increased infection/malignancy risk
high cardiovascular mortality
what is a UTI?
increased risk if impaired bladder emptying or low urinary flow rates
e.coli gram negative bacilli
symptoms of UTI and management?
antibiotics/increased fluid intake
what may cause a urinary tract obstruction?
external compression - abdonminal/pelvic malignancies
what oral problems may renal osteodyrstrophy cause?
loss of lamina dura
problems with bone healing post extraction
why may renal patients have greater bleeding tendencies?
abnormal platelet production, diminished factor 3 and von wilebrands factor
when should you treat a dialysis patient in the dentist and why?
day after dialysis once heparin worn off
what patients may require pep before an invasive procedure?
some on haemodialysis
discuss with renal team
what orofacial manifestations may be seen in renal patients?
osseus lesions - loss of LD, osteoporosis, osteolytic areas, secondary hyperparathyroidism = giant cell lesion, abnormal bone repair
what oral signs may a chronic renal failure patient experience?
dry mouth, halitosis, metallic taste
insidious oral bleeding/purpura, salivary gland swelling
calculus accumulations, oral ulceration and changes b/c anaemia